studying the anti-dandruff effect of althaea officinalis and grape vinegar shampoo: a double-blind, randomized clinical trial

Background: dandruff is an epidermal disorder characterized by scaling, itching, and redness. generally, three causative factors contribute to dandruff: sebaceous gland secretions (particularly when overactive), malassezia fungus, and allergies. marshmallow, scientifically known as althaea officinalis, is recognized as an anti-inflammatory agent for respiratory, digestive, and skin diseases. the marshmallow extract exhibits a potent antifungal effect on malassezia furfur, the fungus responsible for dandruff. objectives: the aim of the present study was to compare the efficacy of an anti-dandruff herbal shampoo containing a. officinalis and grape vinegar with ketoconazole in a double-blind, randomized clinical trial. methods: sixty patients with dandruff were randomly assigned to two groups receiving either ketoconazole 2% or herbal shampoos. clinical examinations were conducted by physicians to assess the rates of scaling, itching, and erythema. the treatment period lasted 8 weeks, with patients returning after 4 and 8 weeks for evaluation. the recovery rate was measured by comparing scores. results: the results indicated that both treatments significantly affected the amount of scaling, erythema, and itching of the scalp after one month; however, no significant difference was observed between the two groups. at the end of the study, the mean scaling index in the herbal and ketoconazole shampoo groups was 1.23 ± 0.21 and 1.11 ± 0.31, respectively. after two months, the mean itching index in the herbal and ketoconazole shampoo groups was 1.75 ± 0.42 and 1.27 ± 0.37, respectively. the mean erythema index in the herbal and ketoconazole shampoo groups was 0.2 ± 0.043 and 0, respectively, after two months. conclusions: according to the results, the herbal shampoo containing marshmallow extract and grape vinegar can be used to treat dandruff as a less costly and less complicated therapy.